Trying to conceive after loss: Your top 10 list of what you must know

After my first loss, my thoughts constantly fell on one of two things: mourning the baby we just lost and dreaming of trying again. As much as I deeply ached to still be pregnant with the child we already conceived, the emptiness in my womb now felt unbearable. I was ready to start trying to conceive after our loss.

But trying again was no longer as simple as just stopping using protection as I needed to recover physically, even though emotionally I was ready. There were a host of decisions and considerations which had to take priority over my aching heart and aching (empty) uterus.

So how do you know when you are ready to start trying to conceive after loss?

After five years and five recurrent losses in trying for a rainbow, here’s what I believe are the top 10 considerations you need to make when trying to conceive after loss:

1. Get the green light from your doctor first.

The decision to try again is as medical as it is personal. Your doctor needs to give you the green light first. For many, that simply means waiting a cycle or two. For others, it means giving your body a chance to heal from surgical interventions, blood loss or other trauma. Your doctor may want to run a series of tests and treat any possible underlying conditions first. Be sure you and your doctor are completely clear about the game plan moving forward, which may include extra monitoring, progesterone supplementation, seeing a reproductive endocrinologist, starting fertility meds, etc.

2. Your own health matters too.

Twice I have been in a potentially life-threatening situation due to pregnancies. My husband was terrified of losing me and was hesitant to try again for that reason. Talking with my doctor and a reproductive endocrinologist about how we would address the risks to my own health helped my husband come back on board with trying again. Pregnancy is equally as much about your body as it is about your baby’s. Consider the toll pregnancy could take and talk to your doctor openly about the risks to your health.

3. I’m not just talking about your physical health.

As a loss mom, you may not only be dealing with grief, but could also be dealing with compounding mental health issues like anxiety, depression or PTSD. As much as possible, get clear on what kind of mental health issues you are facing and create a strategy to help you cope while trying to conceive. Whether it’s medication, therapy, self-care, or exercise, make your mental health a top priority before trying to conceive after a loss. You certainly do not need to be “all better” — but you do need a game plan.

4. Determine your limits.

Sometime after one of my five losses, I asked my OB if I should try again. I’ve since passed on her response to dozens of others:

“Just decide if you can handle one more loss. Not two, not ten …. just one more loss.”

You and your hubby need to decide if you can take one more loss, one more negative pregnancy test, or one more failed cycle. Ask, and keep asking each month, if you think the reward is worth the risk. You can also decide on limits like how long you’ll try or what kind of interventions you are willing to use. My husband and I operated by this rule until my fourth consecutive loss, and I knew I simply could not try any more. The risk felt far too great. My husband had a different opinion, which brings me to …

5. Keep communication open.

Both you and your partner’s opinions count. Equally. (Ok, ok almost equally. I personally think women get a bit more say since pregnancy happens to their body.) While my husband was afraid of losing me, he still agreed to try again because that’s what I wanted. So when he told me he wasn’t done, I reciprocated. I agreed to try one last time for his sake, not mine. Resentment can quickly come in between you when you are not on the same page. So take your partner’s hopes, fears and expectations into consideration as you decide. After all, your relationship is the foundation on which you are building your family.

If you have living children, take stock of your current home life. Will you be able to meet their needs if you are pregnant and possibly battling anxiety, or high-risk pregnancy? Will your children be able to handle the loss of another pregnancy? Have you given adequate time and attention to their grief before you move ahead? Be sure to acknowledge the needs and desires of all those currently living in your family as you decide.

7. Discuss the alternatives.

There are many ways to build a family, with pregnancy just being one of the ways. While you may not have envisioned adopting or surrogacy when you began family planning, it is quite possible that these options might be the best at this point in time. If adoption or surrogacy interest your or your spouse, do your due diligence so you can come to an informed decision together. Remember, adoption is not a consolation prize, and pregnancy is not first place.

At any point, one or all of the above considerations might change. Perhaps your marriage is already too strained, or one of your children has extra high needs. Perhaps the meds you were prescribed had too many side effects and your body needs a breather. You could be struggling with infertility, and may need to take mental and physical breaks. Maybe unrelated circumstances have made being pregnant again unrealistic. Life changes, and your journey for trying to conceive may have to adjust accordingly.

9. It’s not a failure to call it quits.

When my husband urged me to try one last time, we did conceive and carry our rainbow baby to a live birth. But even before she was born, I was ready to take permanent measures to make sure this pregnancy was our last. Some people may pressure you to keep trying and “never give up…” but being honest with yourself and each other about what you can handle, and what you cannot, is not giving up. It’s being smart. And brave. It’s putting your family, your whole family, first.

10. Is it what you want?

I know this is super simplistic, but sometimes you just know if you’re ready or if you’re not. And no checklist can answer to your heart.

Your turn >>> When did you decide it was time to start trying to conceive after loss? What considerations did you have to make? Were you and your partner on the same page?

Are you looking for the hope as you navigate this journey of trying to conceive after loss? Here are 6 daily affirmations you can use. Print and post anywhere to remind you that you that there is hope!

Rachel Lewis is a foster, adoptive and birth mom. After a 5-year battle with secondary infertility and recurrent pregnancy loss, she now has three children in her arms, five children in heaven and a foster son in her heart. She now considers her family complete after the adoption of her second daughter and the birth of her rainbow baby. Rachel understands what it is like when building your family is just a little complicated, and is passionate about helping women feel heard and understood in their struggles. When she’s not chauffeuring her kids around or working on her upcoming book, you can find her shopping at Trader Joes, drinking coffee, or writing about her journey as a mom at The Lewis Note or as a contributor to Still Standing Magazine. You can get her free resource, "Your BFF Guide to Miscarriage: 5 Ways to Comfort a Friend Through Pregnancy Loss" here. Connect with Rachel on Facebook, or join her private Facebook group Brave Mamas -- a support group for anyone who had to struggle to build their family.

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